INDEPENDENCE CENTER


Address: 2443 Prouhet Ave, Saint Louis, MO 63114-1946
Phone: 3148907100

INDEPENDENCE CENTER (NPI# 1174669006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174669006
Entity Type Organization
Organization Name INDEPENDENCE CENTER
Other Organization Name JANE HOWELL STUPP APARTMENTS
Practice Address 2443 Prouhet Ave
Saint Louis
MO 63114-1946
Mailing Address 8675 Olive Blvd
Saint Louis
MO 63132-2503
Practice Telephone 3148907100
Practice Fax Number 3148907133
Mailing Telephone 3143735187
Mailing Fax Number 3143675626
Enumeration Date 2007-01-29
Last Update Date 2020-08-22
Authorized Official Name MR. MIKE KELLER (EXECTUVE DIRECTOR)
Authorized Official Telephone 3145334380
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness 030777 MO Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Jane Howell Stupp Apartments Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1760839260 Independence Center Clinic/Center 4245 Forest Park Ave, Saint Louis, MO 63108-2810 2016-05-16
1619146420 Independence Center Community/Behavioral Health 320 N Ash St, Waukegan, IL 60085-3985 2008-02-26
1699944413 Independence Center Case Management 813 Indiana Ave, Waukegan, IL 60085-2612 2008-02-26
1881863603 Independence Center Case Management 815 Indiana Ave, Waukegan, IL 60085-2612 2008-02-26
1235308057 Independence Center Case Management 817 Indiana Ave, Waukegan, IL 60085-2612 2008-02-26
1427227230 Independence Center Case Management 819 Indiana Ave, Waukegan, IL 60085-2612 2008-02-26
1336318153 Independence Center Case Management 1730 Washington St, Waukegan, IL 60085-5102 2008-02-26
1427227248 Independence Center Case Management 2835 Washington St, Waukegan, IL 60085-4839 2008-02-26
1972772788 Independence Center Case Management 2839 Washington St, Waukegan, IL 60085-4839 2008-02-26
1558494286 Independence Center Community/Behavioral Health 8675 Olive Blvd, Saint Louis, MO 63132-2503 2007-03-13

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities INDEPENDENCE CENTER INC 2025 Washington St, Waukegan, IL 60085-5131
Massachusetts Corporations INDEPENDENCE CENTER LLC 4 Clinton Square, C/o The Clinton Companies, Syracuse, NY 13202
Massachusetts Corporations INDEPENDENCE CENTER NEWCO LLC The Clinton Exchange, 4 Clinton Square, C/o The Pyramid Companies, Syracuse, NY 13202

Office Location

Street Address 2443 PROUHET AVE
City SAINT LOUIS
State MO
Zip Code 63114-1946

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326677519 Kasey Howard Technician 2443 Prouhet Ave, Saint Louis, MO 63114-1946 2020-04-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053926964 Deann Porter Prosthetist 8743 Mavis Place, St Louis, MO 63114 2020-09-09
1255971438 Hughes In Home Services Home Health 9319 Midland Ste B, St Louis, MO 63114 2020-01-15
1740714724 Catherine Kagotho Nurse Practitioner 9915 Broadmoor Dr, Apt 4, Overland, MO 63114 2017-04-17
1073051371 Ruth & Naomi Adult Day Services, Inc Clinic/Center 9443-9445 Lackland Road, St. Louis, MO 63114 2017-02-07
1992103691 Lisa Abernathy Social Worker 9705 Tennyson Court, Saint Louis, MO 63114 2014-12-11
1356626808 William J Norbury Pharmacist 8000 St. Charles Rock Road, Walgreens Pharmacy 4825, St.louis, MO 63114 2011-10-17
1770719700 Total Renal Care Inc Clinic/Center 9030 Saint Charles Rock Rd, Saint Louis, MO 63114 2009-06-04
1710126792 Risingabove Independent Supported Living Assisted Living Facility 2330 # 2 Woodson Road, Overland, MO 63114 2009-02-13
1427215789 Wnf Medical, LLC Durable Medical Equipment & Medical Supplies 1908-2000 Innerhelt Business Center Dr., Suite 1968, Overland, MO 63114 2008-05-22
1891838744 Easter Seals Midwest Day Training, Developmentally Disabled Services 2215 Lackland Road, Overland, MO 63114 2007-02-14
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790038321 Pleasant Solutions Home Health Care,llc Community Based Residential Treatment Facility, Mental Illness 100 Rue St. Francios Suite 107, Saint Louis, MO 63031 2012-10-19
1922358423 Smiley Manor Community Based Residential Treatment Facility, Mental Illness 5415 Thekla, Saint Louis, MO 63120 2012-09-12
1184811101 Frasat LLC Community Based Residential Treatment Facility, Mental Illness 3715 Saint Anns Ln, Saint Louis, MO 63121-4813 2007-10-03
1922298777 Oasis Residential Care Inc Community Based Residential Treatment Facility, Mental Illness 5626 Maffitt Ave, Saint Louis, MO 63112-4010 2007-07-27
1881806743 Oasis Residential Care Inc Community Based Residential Treatment Facility, Mental Illness 3508 Prairie Ave, Saint Louis, MO 63107-2214 2007-05-04
1396863031 Mccb Transitions, Inc. Community Based Residential Treatment Facility, Mental Illness 4110 Saint Louis Ave, Saint Louis, MO 63115-3218 2007-03-27
1780720680 Independence Center Community Based Residential Treatment Facility, Mental Illness 19 N Newstead Ave, Saint Louis, MO 63108-2260 2007-01-29
1366646481 Mccb Transitions, Inc. Community Based Residential Treatment Facility, Mental Illness 4110 Saint Louis Ave, Saint Louis, MO 63115-3218 2007-06-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1720642010 Southview Health Care, LLC. Community Based Residential Treatment Facility, Mental Illness 951 Creamery Rd, West Plains, MO 65775-6052 2019-04-23
1902369663 Anna Dodson Home LLC Community Based Residential Treatment Facility, Mental Illness 4616 Hwy D, Farmington, MO 63640-7241 2019-04-10
1760940209 Lea-ed Inc Community Based Residential Treatment Facility, Mental Illness 30 Sherman Road, Lemay, MO 63125 2019-03-04
1467919233 Ted-lea, Inc. Community Based Residential Treatment Facility, Mental Illness 9444 Midland Blvd, Overland, MO 63114-3328 2019-02-27
1639633290 Synergy Executive, LLC Community Based Residential Treatment Facility, Mental Illness 2608 Smyrna Rd, Ozark, MO 65721-7674 2019-01-29
1467958553 Swope Health Services Community Based Residential Treatment Facility, Mental Illness 2614 Benton Blvd, Kansas City, MO 64127-4149 2018-04-05
1053827964 Dianas Boarding Home Inc Community Based Residential Treatment Facility, Mental Illness Hc 64, Box 4683, Marble Hill, MO 63764 2017-12-15
1689098188 Venus Independent Living LLC Community Based Residential Treatment Facility, Mental Illness 301 S Coffey St, Vienna, MO 65582-8862 2014-02-05
1699108381 Sunny Hill, Inc. Community Based Residential Treatment Facility, Mental Illness 134 Gray St, Festus, MO 63028-1949 2013-08-16
1902167067 Support Professionals II Community Based Residential Treatment Facility, Mental Illness 8540 Blue Ridge, Kansas City, MO 64138 2012-06-06
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Competitor

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City SAINT LOUIS
Zip Code 63114

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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